Names and pronunciation
(eye-da-roo-siz′uh-mab) Praxbind
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Drug reference
(eye-da-roo-siz′uh-mab) Praxbind
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Func. class.: Antidote (dabigatran)
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Chem. class.: Monoclonal antibody
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Do not confuse: Praxbind/digibind Idarucizumab/idarubicin
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ACTION: A humanized monoclonal antibody frag- ment (Fab) that binds specifically to dabigatran and its acylglucuronide metabolites with a higher affinity for dabigatran to thrombin and neutralizes the anticoagulant effect within minutes
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USES: Reversal of dabigatran
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CONTRAINDICATIONS: Hypersensitivity, fructose intolerance, sobitol parenterally, children <18 yr Precautions: Pregnancy, breastfeeding, liver disease
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SIDE EFFECTS CNS: Headache, delirium GI: Constipation MISC: Hypersensitivity (fever, pruritus, rash) RESP: Bronchospasm, pneumonia CV: Thrombotic event GU: UTI
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INTERACTIONS: None known Drug/Lab: Increase: aPtt, ecarin clotting time (ECT) Decrease: Potassium NURSING CONSIDERATIONS
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DOSAGE AND ROUTES Adult IV Bolus: 5 g (given as 2 separate 2.5-g/50 mL doses no more than 15 min apart)
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Available forms: Injection 2.5 g/50 mL in single-use vials
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Administer: IV route • For IV use only • Do not shake • Prior to use, flush preexisting IV line with NSS • Give dose undiluted as an IV bolus by syringe or as an infusion by hanging the vials • Do not mix with other drugs or give any other infusion in the same IV line • Give promptly once solution has been removed from vial. Infusion of each vial should take no longer than 5 to 10 min, with the second vial of 2.5 g administered no later than 15 min after the end of the first 2.5-g vial • Store intact vials at 2°C to 8°C (36°F to 46°F) in original packaging (to pro- tect from light), do not freeze. May store intact vials in the original pack- aging (to protect from light) at room temperature, 25°C (77°F), for up to 48 hr or up to 6 hr if exposed to light
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Assess: • Thrombotic risk: Resume anticoagu- lant treatment as soon as possible to de- crease the risk of thrombosis formation, may restart after 24 hr • Hypersensitivity: Assess for hypersen- sitivity (bronchospasm, fever, pruritus, dyspnea, rash); hereditary fructose intol- erance, product contains sorbitol • Pregnancy/breastfeeding: No well- controlled studies, use only if clearly needed, cautious use in breastfeeding
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Evaluate: • Therapeutic response: Dabigatran re- versal
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Patient and caregiver information: • Reason for product and expected re- sult • To notify provider of bleeding or clots (numbness, weakness on one side of the body; pain, redness, tenderness, warmth, swelling in the arms or legs; change in color of an arm or leg; chest pain; short- ness of breath; coughing up blood); al- lergic reaction (rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest, throat; trouble breathing, swal- lowing; swelling of the mouth, face, lips, tongue, throat) • Pregnancy/breastfeeding: To notify provider if pregnancy is planned or suspected or if breastfeeding HIGH ALERT
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PHARMACOKINETICS Onset a few minutes, peak unknown, duration 24 hr, half-life 10.3 hr
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